TY - JOUR
T1 - Efficacy and Safety of the Modified EPOCH Regimen (Etoposide, Vincristine, Doxorubicin, Carboplatin, and Prednisolone) for Adult T-cell Leukemia/Lymphoma
T2 - A Multicenter Retrospective Study
AU - Tsukamoto, Yasuhiro
AU - Kiyasu, Junichi
AU - Choi, Ilseung
AU - Kozuru, Mitsuo
AU - Uike, Naokuni
AU - Utsunomiya, Hayato
AU - Hirata, Akie
AU - Fujioka, Eriko
AU - Ohno, Hirofumi
AU - Nakashima, Eriko
AU - Nakashima, Yasuhiro
AU - Miyashita, Kaname
AU - Tachikawa, Yoshimichi
AU - Narazaki, Taisuke
AU - Tsuda, Mariko
AU - Haji, Shojiro
AU - Takamatsu, Akiko
AU - Tanaka, Emi
AU - Goto, Tatsuro
AU - Takatsuki, Hiroshi
AU - Oyama, Makoto
AU - Muta, Hiroki
AU - Yagi, Yu
AU - Ikeda, Motohiko
AU - Matsushima, Takamitsu
AU - Yufu, Yuji
AU - Suehiro, Youko
N1 - Funding Information:
The authors would like to dedicate this article to the memory of Dr Koichiro Muta and Dr Yasunobu Abe who contributed substantially to the execution of this study but sadly passed away before its completion. They are also grateful to Keiko Yamaguchi (National Hospital Organization Kyushu Cancer Center), Mika Gyotoku, and Chinami Era (Iizuka Hospital) for their clerical support.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/7
Y1 - 2020/7
N2 - Background: We retrospectively analyzed patients with untreated aggressive adult T-cell leukemia/lymphoma who received the modified EPOCH (mEPOCH) regimen. Patients and Methods: Patients received up to 6 mEPOCH cycles. Etoposide (50 mg/m2/day), doxorubicin (10 mg/m2/day), and vincristine (0.4 mg/m2/day) were each given as a continuous 96-hour infusion on days 1 to 4. Prednisolone (40 mg/m2/day) was given intravenously or orally on days 1 to 4 and then tapered and stopped on day 7, and carboplatin (dose calculated for each patient individually using Calvert's formula according to a target under the curve of 3 mg/mL/min) was given as a 2-hour intravenous infusion on day 6. Results: In 103 patients, overall response rate and complete response rate were 58% and 25%, respectively. With a median follow-up of 8.9 months, the median survival time was 9.8 months (95% confidence interval, 7.2-13.9 months). The median progression-free survival (PFS) was 4.2 months (95% confidence interval, 3.4-5.7 months). Patients who completed ≥ 4 cycles experienced significantly better overall survival and PFS compared with those who completed < 4 cycles. Twenty-eight patients underwent allogeneic hematopoietic stem cell transplantation after mEPOCH and demonstrated significantly prolonged overall survival and PFS compared with those who did not undergo transplantation. Conclusion: The mEPOCH regimen is effective with tolerable adverse effects and may be an alternative treatment option for adult T-cell leukemia/lymphoma.
AB - Background: We retrospectively analyzed patients with untreated aggressive adult T-cell leukemia/lymphoma who received the modified EPOCH (mEPOCH) regimen. Patients and Methods: Patients received up to 6 mEPOCH cycles. Etoposide (50 mg/m2/day), doxorubicin (10 mg/m2/day), and vincristine (0.4 mg/m2/day) were each given as a continuous 96-hour infusion on days 1 to 4. Prednisolone (40 mg/m2/day) was given intravenously or orally on days 1 to 4 and then tapered and stopped on day 7, and carboplatin (dose calculated for each patient individually using Calvert's formula according to a target under the curve of 3 mg/mL/min) was given as a 2-hour intravenous infusion on day 6. Results: In 103 patients, overall response rate and complete response rate were 58% and 25%, respectively. With a median follow-up of 8.9 months, the median survival time was 9.8 months (95% confidence interval, 7.2-13.9 months). The median progression-free survival (PFS) was 4.2 months (95% confidence interval, 3.4-5.7 months). Patients who completed ≥ 4 cycles experienced significantly better overall survival and PFS compared with those who completed < 4 cycles. Twenty-eight patients underwent allogeneic hematopoietic stem cell transplantation after mEPOCH and demonstrated significantly prolonged overall survival and PFS compared with those who did not undergo transplantation. Conclusion: The mEPOCH regimen is effective with tolerable adverse effects and may be an alternative treatment option for adult T-cell leukemia/lymphoma.
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U2 - 10.1016/j.clml.2020.03.008
DO - 10.1016/j.clml.2020.03.008
M3 - Article
C2 - 32312633
AN - SCOPUS:85083326449
SN - 2152-2650
VL - 20
SP - e445-e453
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 7
ER -
